Surgical treatment of nonseverely obese patients with type 2 diabetes mellitus: sleeve gastrectomy with ileal transposition (SGIT) is the same as the neuroendocrine brake (NEB) procedure or ileal interposition associated with sleeve gastrectomy (II-SG), but ileal interposition with diverted sleeve gastrectomy (II-DSG) is the same as duodenal switch

AbstractObjectives: To determine and compare the efficacy of two weight-reducing surgicalinterventions, gastric bypass (GBP) and sleeve gastrectomy (SG), in inducingremission/improvement of type 2 diabetes mellitus (T2DM). Materials and Methods:Data were collected from 162 obese T2DM subjects who underwent SG (96) or GBP(66) between 2009 and 2011. The following parameters were recorded: body massindex, waist-hip-ratio, blood pressure, fasting plasma glucose, HbA1c, lipid profile,hypoglycemic drugs used. Results: Remission of T2DM was achieved in 83% ofpatients who underwent SG and in 81% of patients who underwent GBP. For bothprocedures, T2DM remission rate was higher for patients with a shorter duration ofT2DM, with better preoperative glycemic control and for those not requiringpharmacological agents before surgery. Conclusions: SG and GBP are effective ininducing T2DM remission in obese patients. The clinical features of T2DM areimportant predictors for the remission of the disease after bariatric surgery.

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Improvement of Type 2 Diabetes Mellitus in Obese and Non-Obese Patients after the Duodenal Switch Operation

Journal of Obesity ◽

10.1155/2011/860169 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 11

Author(s):

M. Frenken ◽

E. Y. Cho ◽

W. K. Karcz ◽

J. Grueneberger ◽

S. Kuesters

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Duodenal Switch ◽

Gastric Bypass Surgery ◽

Morbidly Obese ◽

Diabetic Patients ◽

Model Assessment ◽

Obese Patients

Introduction. Type 2 diabetes mellitus (T2DM) is one of the most important obesity-related comorbidities. This study was undertaken to characterise the effect of the biliopancreatic diversion with duodenal switch (BPD-DS) in morbidly obese and nonmorbidly obese diabetic patients.Methods. Outcome of 74 obese diabetic patients after BPD-DS and 16 non-obese diabetic patients after BPD or gastric bypass surgery was evaluated. Insulin usage, HbA1c-levels, and index of HOMA-IR (homeostasis model assessment of insulin resistence) were measured.Results. A substantial fraction of patients is free of insulin and shows an improved insulin sensitivity early after the operation, another fraction gets free of insulin in a 12-month period after the operation and a small fraction of long-term insulin users will not get free of insulin but nevertheless shows an improved metabolic status (less insulin needed, normal HbA1c-levels).Conclusion. BPD-DS leads to an improvement of T2DM in obese and non-obese patients. Nevertheless, more data is needed to clarify indications and mechanisms of action and to adjust our operation techniques to the needs of non-obese diabetic patients.

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